Milk supply--how much is needed?
I am new to the board--have a premie born 7 wks, 1 day ago, still in NICU. We're working on breastfeeding and I've been pumping since day one. I was lucky enough to get milk (colostrum) on day one, but have struggled with supply since then. I realize this is a common problem among premie moms. I've been on Reglen twice--and struggled with the drowsiness, but had excellent outcome. However, once I stop taking the Reglen, my supply dropped by 20% (was getting 850 mL per day, now I'm getting about 700-750mL per day). The supply I'm getting is more than enough to feed my little one now as he currently takes 30mL every 3 hours, however, at times I'm pumping less than 30mLs, so not sure what that would mean when he came home (probably have to supplement). The lactation consultant has really scared me into thinking I'm not getting enough. She suggests Domperidone, however I'm not game on taking something that the FDA warns against (also I had heart complication several weeks ago and the risk of arrythmia scares me). I tried Mother's Milk and More Special Blend early on, but gave up on those as they only increased 5 mL/day.
I guess my question is twofold: 1) what do I need to be getting in terms of supply now and at discharge (we're looking at him being there another couple of weeks as he's only 3.5 lbs and still needs to be able to feed on his own all feeds), and 2) what have others done to help increase their supply?
I should note I am diligent with the pumping 8 times daily.
Thanks for any and all advice!
Re: Milk supply--how much is needed?
For me, the answer was that the pump just wasn't getting everything out. Some say it only empties about 30% of what's there where the baby can easily get out 70%, but the breast is really never empty. I swear by hand expression. Watch this video and give it a try: https://newborns.stanford.edu/Breastfeeding/MaxProduction.html and https://newborns.stanford.edu/Breastfeeding/HandExpression.html . I would get out another 15-30 mls after pumping once I got good at it and better emptying= more milk! It's a learned skill that takes several days to master, so try to be patient. It's worth a shot at least. Early on, it is helpful to have a good supply so the baby won't have to work hard to get to the milk, but remember your baby may empty the breast better than the pump and you may let down more. In the meantime- tons of skin to skin and putting the baby to the breast! Good luck! It's not easy for us preemie moms! ((HUGS))
edit: readability
There are more suggestions on the blog too: https://preemiemomblog.blogspot.com/p/all-things-breastmilk.html
BFP#2 3/16/11, beta 138; 4/12 Baby/HB DS born 9/10/11 at 29w4d due to partial abruption and PTL
BFP#3 8/19/13 Another boy! 17P, modified bedrest and Nifedipine helped us have a termie! DS2 born 4/19/14 at 38w5d.